An end to HIV in decade? First, Atlanta must catch up to other cities

President Donald Trump had been speaking for nearly an hour when he finally arrived at the place in his State of the Union address for which Dr. Melanie Thompson had been waiting.

After taking the helm of the Centers for Disease Control and Prevention last April, Dr. Robert Redfield had made the bold statement that the U.S. could end its HIV epidemic in three to seven years and started conversations about how to better coordinate the federal government’s response to achieve that.

Thompson was hopeful but she knew it was a long shot the president would even mention HIV.

Then at exactly 9:56 p.m., there it was.

“In recent years, we have made remarkable progress in the fight against HIV and AIDS,” the president said during the Feb. 5 speech. “Scientific breakthroughs have brought a once-distant dream within reach. My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. Together, we will defeat AIDS in America.”

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Thompson, interim chair of the Fulton County HIV/AIDS Prevention, Care and Policy Advisory Committee, has spent the past 30 years trying to do that very thing, caring for people living with HIV, trying to prevent its spread, researching new drugs, and working at the national and local level to influence policy and create plans to end the epidemic.

The president’s announcement, however lacking in details, she said, reflects the work Redfield and others had been doing for months.

“There was a lot under the hood of that sentence in the State of the Union,” she said.

ExploreReaction from HIV and LGBTQ activists was swift.

Daniel Driffin, founder of the nonprofit THRIVE SS, is hopeful. In addition to new strategic and innovative ways to end the epidemic, he said same-day treatment options for all are needed sooner rather than later.

What’s more, innovations must bolster treatment for people living with HIV, and prevention with pre-exposure prophylaxis or PrEP for those who are negative, he said.

Credit: The Atlanta Journal-Constitution

Credit: The Atlanta Journal-Constitution

Prioritizing HIV in Trump’s speech was for sure a big moment, but as far as Jeff Graham, executive director of Georgia Equality, is concerned, an end to the epidemic won’t be realized if we continue to have policies in place that stigmatize and discriminate against people who are LGBTQ, immigrants, people of color or women.

“Increased funding for pre-exposure prophylaxis as well as increased funding for medications and the support services that help keep people in care are desperately needed,” he said. “We also need to ensure that there is adequate funding for housing, for syringe services programs and access to comprehensive sexual education.”

Given the ever-increasing numbers of new diagnoses in Georgia and other Southern states, you have to wonder if ending the epidemic in 10 years is even possible.

Thompson, cautiously, thinks so.

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“I tend to be an optimist who is also pretty grounded in reality,” she said. “Theoretically, we have the tools to do this, but it is very complicated and it will take a very broad and integrated approach, requiring unprecedented leadership from the local community and coordination of services in addition to money.”

Just talking about an end to the epidemic presents its own set of problems. People start to think it’s already over, forgetting that not only does Georgia have the highest rate of new HIV diagnoses in the country, people here are still dying from AIDS.

According to the CDC, there were 15,807 deaths among people with diagnosed HIV in the U.S. in 2016. Nearly half — 47 percent — of these deaths were in the South.

“Right now, we are simply not on track to end AIDS in Atlanta or Georgia,” she said. “Unlike cities like New York and San Francisco that have experienced declines in new diagnoses each year, Atlanta numbers have remained steady. Fulton County alone has about the same number of people living with HIV as the entire city of San Francisco.”

Credit: Robert Dibrell

Credit: Robert Dibrell

In 2017, San Francisco had 221 new HIV diagnoses compared to about 700 in Fulton County. While new diagnoses in San Francisco decreased by more than half over a decade and New York City’s by over 40 percent, Fulton County’s have been relatively flat. Metro Atlanta had over 1,600 new diagnoses in 2017, more than seven times as many as San Francisco, and over 32,000 people living with HIV. Most are African-Americans.

Take a moment if you need it to wrap your head around that. It’s a lot, right?

Why have they been able to do that and we haven’t?

Come back next week and I’ll tell you what Dr. Thompson had to say about that.

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